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Pregnancy: the beginning of the end - October 28, 2015

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Pregnancy is associated with continuous expectation. First, a woman hopefully waits for the results of the tests, then she waits for the toxicosis to disappear, then she waits for the first opportunity to see the baby on the screen of the ultrasound scanner, then she waits for the start of maternity leave in order to fully devote herself to preparing for the birth of a son or daughter. But after the 30th week, all the thoughts of a pregnant woman revolve around one event - the immediate upcoming birth.

If a woman has already gone through this stage, then her expectations in the last weeks of her term are rather of an observational nature: she would not miss it. But in the first pregnancy, the anticipation of the onset of labor is scary. Women now and then turn to their girlfriends who have given birth with the same questions: how to understand that childbirth has begun?

The female body is designed in such a way that for such an important event as the birth of a child, it begins to prepare in advance. Of course, under the influence of negative factors such as stress, unusual physical activity, change of time and climate zones (if a woman travels in the last weeks of pregnancy), childbirth can begin prematurely, but in most cases it is still worth talking about the systematic preparation of the body.

30-35 weeks

Around week 30, the expectant mother begins to experience rare, irregular and initially painless uterine contractions. This usually happens when the body is in a horizontal position. The abdomen hardens for a few seconds, some women feel a decrease in the sensitivity of its skin. These are Braxton Hicks contractions - training contractions of the uterus, which is preparing for more serious stress. No treatment is required in this case. You can relieve discomfort by taking a warm shower and “breathing” with your stomach for a couple of minutes. Usually, doctors advise putting your hand at the level of the navel and breathing so that the hand rises during inhalation and falls as you exhale.

Approximately at 32-34 weeks, the musculoskeletal system begins to prepare for childbirth. Usually women feel a pulling pain in the sacrum and thighs, the gait turns into a duck, that is, the woman walks, waddling from side to side. During this period, breathing exercises and stretching exercises will be very helpful. “I advise women to do butterfly or cat exercises,” says fitness trainer Marina Efanova . - For the first, you need to sit on the floor and bend your legs so that the feet are connected to each other, the heels are pressed to the crotch, and the knees look in different directions. You need to lightly press your hands on your knees, as if trying to press them to the floor, in order to feel how the inner surface of the thigh is stretched. If you perform this exercise daily, the muscles will become more elastic due to increased blood supply.

The cat exercise is performed on all fours. It is necessary to alternately round the back and bend it as low as possible. At the same time, you should try to arch your back up in the waist area, and bend in the area of ​​​​the shoulder blades. Massage and swimming will also help prepare the muscles for labor. By the way, small physical activity will help get rid of another unpleasant sensation - pulling pains in the lower abdomen.

At this time, the baby turns its head towards the exit, so the pregnant woman's stomach drops, it becomes easier to breathe, heartburn and heaviness in the stomach disappear, but, on the other hand, pressure on the bladder increases. Microlosses of urine when coughing and sneezing become unpleasant companions of the expectant mother. At the same time, mucous discharge from the vagina increases - partly due to changes in the hormonal background, partly due to the increasing pressure of the fetus on the pelvic organs. In the same period, the swelling of the lower extremities also increases.

Another indicator of the approaching "moment X" is the nesting instinct. About three to four weeks before giving birth, a woman suddenly has an irresistible desire to make repairs, clean the apartment, rearrange the furniture or even change it. Psychologists advise the relatives of a pregnant woman to let her throw out her surging desires, naturally, within reason. Let him sort out the trash in the pantry or rub grandmother’s silverware to a shine, but it’s better to protect the expectant mother from hard work and unnecessary worries.

This is the finish line, where any day can become a holiday for the family. During this period, a woman should listen carefully to her condition and observe the changes taking place in the body. First of all, you should pay attention to the mucous secretions. If they look like a piece of melted jelly with small streaks of blood or brown color and their volume is about a tablespoon, then this is a mucous plug. She is a clear harbinger of the onset of childbirth. In some women, the mucus plug leaves a few days before labor, in others - just before it begins, so from this moment you need to be on the alert.

The second sign of the imminent appearance of the baby is true contractions. With the first pregnancy, they can last from eight to twelve hours, with the second or more - from five to eight hours.

How to distinguish false contractions from true ones
- False contractions are irregular, while true ones have a clear periodicity, getting stronger every hour. If within an hour a woman experiences six or more bouts of contractions, which gradually increase, then with a high probability we can talk about the onset of labor.
- False contractions last 10-20 seconds and disappear without a trace if you take a warm shower. True ones last 30 seconds or more and do not go away even after a shower.
- If between contractions a woman feels well and can fall asleep, then most likely these are false contractions. When true, the body begins to work hard, pressure rises, appetite drops, dizziness, headaches and muscle pains (in the back, hips) may appear, so the woman feels discomfort.
- During false contractions there is no mucous discharge from the vagina, while true ones are often accompanied by discharge mixed with blood

As mentioned earlier, training contractions begin as early as the 30th week of pregnancy, gradually they become more frequent. How to determine how training (otherwise they are also called false) contractions differ from real, generic ones?

There are several clear indicators for this:

• Regularity. False contractions are irregular, true contractions gradually become stronger, longer and more frequent. However, sometimes in the evenings there are periods of regular contractions (for two or four hours), which then go away on their own. It is better to write down the time and duration of contractions in a special notebook - it will help you cope with the excitement, and it will be useful for the doctor to assess your condition.
• Duration. False contractions last 15-20 seconds, true contractions gradually become longer. If the expectant mother managed to fall asleep peacefully between contractions, then they were false.
• You can take a warm shower or bath. False contractions will disappear, true contractions will continue.
• Well-known American pediatricians William and Martha Cerza suggest the following method: if a woman doubts whether she has begun labor or not, you need to follow the nature of the contractions for an hour. Labor (true) contractions last an average of 10-12 hours for the first birth and 6-8 hours for repeated ones.

Normally, amniotic fluid drains at the end of the first stage of labor, when the cervix is ​​dilated to seven centimeters or more. But sometimes it happens even earlier, sometimes even before the start of contractions. What is important to pay attention to if a woman's water has broken?

• Color: normal water should be light and transparent, white flakes are also acceptable - this is a cheese-like lubricant. Dark, greenish-brown water is a warning sign of fetal hypoxia
• Odour: Normal amniotic fluid is odorless. An unpleasant smell may indicate that the baby is passing meconium - the original feces.
• Quantity of water: there are usually about 1-1.5 liters. 500-700 ml - insufficient volume, often occurs with a post-term pregnancy. However, do not rush to diagnose yourself. Sometimes only the so-called anterior waters leave at first, while the fetal bladder itself may still remain intact. In this case, the amount of amniotic fluid can be quite small - about 200-300 ml.

In any case, if a pregnant woman's water has broken, then labor should begin within 24 hours, so it's better not to delay the preparations. After the waters break, the nature of the contractions changes, they become stronger and more painful.

So, when is the time to go to the hospital?

• If within an hour a woman feels about ten contractions with a break of 5-7 minutes.
• If the duration of each contraction is 30-60 seconds.
• If the amniotic fluid broke - especially if it happened at one moment - the water rushed in a stream.

Serious symptoms for which you need to go to the hospital urgently:

• Unexpected bleeding (more than during normal menstruation).
• Sudden pain in the uterine region - not at all the same as pain during contractions.
• Constant dizziness.

Each woman in labor begins and proceeds differently. For some, it’s like a textbook, when contractions develop gradually, the intervals between them gradually decrease, for others everything is rapid, their contractions are immediately painful, and the intervals between them are short. For the third, the first period, on the contrary, is delayed. A woman needs to be guided by her condition and constantly keep her doctor, if any, up to date.

When I first got pregnant, nine months seemed like a very long time. But, as you know, no pregnancy can last forever, so this term is coming to an end. For any woman in labor, the doctor will certainly set the expected date of birth. But, despite this, the real birthday of the baby may differ significantly from the planned date. The thing is, every pregnancy is different. A period of 37 and 42 weeks is considered normal. Moreover, such a pattern was noticed: if the menstrual cycle of the expectant mother was short - 21 days, then, most likely, the pregnancy will end at 38-39weeks. And in women with a long cycle (up to 36 days), pregnancy continues until 41-42 weeks. However, experts remind you that if, nevertheless, the gestation period approaches 40 weeks, and the baby is in no hurry to be born, you need to regularly visit a doctor who will monitor the child's condition using cardiotocography, ultrasound and Doppler.

Photo: Photo from Shutterstock.com

Inna Miller

Pregnancy Maternity Hospital Childbirth

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